Management of Liposarcoma in NCKUH

惡性脂肪肉瘤治療

楊學穎(Hsueh-Ying Yang) ； 潘信誠(Shin-Chen Pan) ； 謝式洲(Shyh-Jou Shieh)

《臺灣整形外科醫學會雜誌》 20卷2期 (2011/06) Pp. 112-119

https://doi.org/10.7096/TJTSPS.201106.0112

摘要

背景：
惡性脂肪肉瘤是常見的軟組織惡性肉瘤，大約佔成人惡性肉瘤五分之一。疾病多發生於四十歲以上，男性略多於女性。最常發生的位置爲肢端，特別是大腿，以及後腹腔。
目的及目標：
我們蒐集過去十五年來本院整形外科惡性脂肪肉瘤病例系列並提出經驗分享。
材料及方法：
本系列是利用回溯性統計成大醫院整形外科於1994年至2009年對於治療惡性脂肪肉瘤之經驗分享。藉由病歷回顧，患者之基本資料、腫瘤型態及特徵以及治療方式皆加以記錄。
結果：
從1994年至2009年，共十九名惡性脂肪肉瘤患者於本院整形外科治療。其中有十一名男性八名女性，年齡從25至82歲，平均59.5歲。有十三名病患病灶位於大腿、三名位於臀部、三名位於小腿。平均追蹤時間爲30.0個月。本系列所有病患皆有進行手術腫瘤切除。平均腫瘤大小15.0公分。其中有十四名病患接受術後輔助治療，三名同時有接受放射治療及化學治療，其餘則行放射治療。在病理組織分類方面，本系列有十三例屬良好分化型、六例屬黏液樣型。有六名病患於術後發生局部復發，兩名發生遠端轉移，並沒有因疾病而造成死亡的患者。
結論：
在我們的病例系列中，黏液樣型的惡性脂肪肉瘤比起良好分化型具有較高的復發率。因此，我們建議如果組織病理顯示病灶爲良好分化型惡性脂肪肉瘤，則完整切除腫瘤即足夠，若腫瘤邊緣並未切除乾淨，則需行輔助性放射治療。如果組織病理顯示爲黏液樣脂肪惡性腫瘤，則除廣泛性切除治療外，需再加以輔助性放射治療。

並列摘要

Background:
Liposarcoma is a common soft tissue sarcoma, which account for almost one fifth of all soft tissue sarcoma in adults. It often occurs at the age older than forty, and is a little more common in male patients than in female patients. The most common site is the extremity, especially the thigh, and the retroperitoneum.
Aim and Objectives: we collect our cases of liposarcoma from the past 15 years and present our experience.
Materials and methods:
This series was a retrospective analysis of consecutive adult patients with liposarcoma treated in the Department of Plastic Surgery at National Cheng Kung University Hospital from 1994 to 2009. The patients whose ICD-9-CM code range from 171.0~171.9 were included for data search. The definite diagnosis was searched by chart review. The patients with liposarcoma diagnosis were included in this study. The patient demography, tumor characteristics, clinical management were all reviewed.
Results:
From 1994 to 2009, nineteen patients with liposarcoma were collected in a retrospective study. There were 11 males and 8 females in this group. The age ranged from 25 to 82 years with an average of 59.5 years. The tumors located at thigh area in 13 patients. Three patients had liposarcoma at buttock. Three were at calf area. The average follow-up time is 30.0 months. All nineteen patients underwent tumor excision and primary closure with or without adjuvant therapy. The tumor size ranges from 6cm to 28cm. The average size is 15.0 cm. Fourteen patients received adjuvant therapy. Three of them received both chemotherapy and radiotherapy, the others received radiotherapy only. The histopathology showed 13 well-differentiated types, 6 myxoid types. Six patients had local recurrence of tumor after surgery. Two patients presented with distant metastasis after tumor excision. No disease-related mortality is noted.
Conclusion:
In our series, myxoid type of liposarcoma has a higher rate of recurrence compared with well-differentiated type. If the pathology showed well-differentiated liposarcoma, complete exicision with free surgical margin is enough. If the margin is not free, adjuvant radiation is recommended. If the pathology revealed myxoid liposarcoma, radical surgical treatment with adjuvant radiotherapy is indicated.

並列關鍵字

liposarcoma